Delivery of Nursing Care Case Study Example | Topics and Well Written Essays - 2500 words

Delivery of Nursing Care - Case Study Example The nurses in the intensive care unit have extensive roles and duties upon them that have to be performed with great precision and care. The management of the brain dead patient and his family is a very important part of the duty of intensive care unit nurses and extensive knowledge with regard to this subject is needed for the nurses to have expertise in this management. Accurate skills and knowledge are required by a nurse to assess a patient as being brain dead. The nurse should be able to effectively differentiate between brain death and cardiac death and should be able to explain to the family that brain death is a condition which cannot be reversed. She should also possess skills to counsel the family to allow for the organ donation of their patient. It is also the duty of the nurse to provide care to the patient so that his organs may be preserved for harvesting. The case of Joanne is also similar to who is a brain dead patient in the intensive care unit. Joanne has suffered f rom a ruptured berry aneurysm. A ruptured berry aneurysm is a common cause of hemorrhage in the brain and it is associated with a mortality rate of 50% (Yachnis and Rivera-Zengotita 2013). Her family is on their way and it is the nurse who has to manage the family upon the arrival. The nurse should inform the family regarding the situation of Joanne and provide support to the family. At the same time, the family should also be counseled for approval for organ donation. Pathophysiology of Berry Aneurysm A berry aneurysm is a point where a blood vessel in the Circle of Willis is weak and dilated. This weakness is mainly due to shortcomings in the proper formation of an artery, particularly at the points where they divide. The arteries at the weak points in the aneurysms only comprise of endothelium and an adventitia. The elastic lamina is not developed and the other muscular layers are also not structurally well-formed. A rise in the intravascular pressure at these points results in f urther dilatation which leads to rupturing of these aneurysms (Rubin and Reisner 2009).  

Reproductive System Assignment Example | Topics and Well Written Essays - 1000 words

Reproductive System - Assignment Example Julia had been working as a computer engineer in an information technology firm and she described her job as â€Å"moderately successful†. She had never been pregnant in her life. Her menses had started at the age of 12 years and had been fairly normal regarding frequency, duration and bleeding. She had become sexually active at the age of 19 years and had variably used diaphragms, condoms and oral contraceptive pills for contraception. She weighed normal for her height, was a non smoker and occasionally consumed alcohol on social occasions. Apart from few episodes of urinary tract infection, last one 2 years back, her other medical and surgical history was remarkable. Ross was an architect and content in his professional and personal life. He had no significant medical, surgical or sexual history. He was physically very active and a non smoker. When they visited the infertility specialist, both of them were questioned regarding their medical and sexual history. They were educ ated regarding the physiology of reproduction and the possible causes of their infertility. Regarding the female reproductive system, description of the organs of reproduction in female and the steps of oogenesis and menstrual cycle was explained: Female reproductive system, oogenesis and menstrual cycle Organs involved in reproduction in a female are ovaries, fallopian tubes, uterus and vagina internally and external genitalia and mammary glands externally. Ovaries are small glands located on the sides of uterus. Germ cells in the ovary are referred to as ooogonia. At nearly 8 weeks of gestation, oogonia become primary oocytes by entering prophase of first meiotic division andundergo further change only before ovulation. A layer of granulosa cells surround this oocyte to form a primordial follicle. Out of all of the follicles, one follicle becomes dominant 5-7 days after menses (Knobil & Neill 2006). Due to hormonal action, meiosis is resumed and expulsion of the egg and follicular fluid occurs. This expulsion is called ovulation. Uterus is the organ where implantation of a fertilised egg occurs. Fertilisation itself occurs in the fallopian tube which connects ovary to the uterus. Cyclic shedding of the internal lining of the uterus called endometrium occurs every 28-30 days in a process called menstruation. This cycle is regulated by a complex interaction of hormones produced by the hypothalamus, pituitary and ovaries (Look, Heggenhougen & Quah 2011). Menstrual cycle has two parts: follicular or proliferative phase; and luteal or secretory phase. Follicular recruitment is caused by FSH. Estrogen causes LH surge for ovulation. These steps take place during follicular phase which technically begins on the first day of menses and lasts for around 14 days (Carr & Wilson 1987). Figure 1. Female reproductive system (www.patients.co.uk 2012) Figure 2. Oogenesis and menstrual cycle (Carr & Wilson 1987) Corpus luteum remains after ovulation and is responsible for sec retory phase of the endometrium. If fertilisation does not take place, it degenerates after 10-14 days and this leads to shedding of the endometrial lining and bleeding (Knobil & Neill 2006). Thus, the couple were explained about oogenesis and menstrual cycle with the aid of above illustrations. Only when these hormonal and tissue changes occur in tandem, fertilisation can take place. Any hormonal or endocrine disorder such as that of hypothalamus, pit